Tetrodotoxin

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Background

  • Neurotoxin found in several marine animals (pufferfish, certain angelfish, blue-ringed octopus)
    • Heat-stable toxin not destroyed by washing, freezing or cooking
  • Blocks neuronal action potential by blocking voltage-gated sodium channels
  • Consumption of improperly prepared pufferfish responsible for vast majority of human toxicity
Blue-ringed-octopus.jpeg

Clinical Features

Onset of symptoms usually within 30 min to 4 hours after eating pufferfish

Differential Diagnosis

Marine toxins and envenomations

Evaluation

  • Pufferfish can be tested for the toxin, but decision to treat should be based on clinical picture
  • Evaluate for other treatable causes of symptoms

Management

Disposition

  • Admit, may need ICU

See Also

External Links

References

  1. Tintanelli's